A 35-year-old metalworker presents to the emergency with suspected intraocular foreign body (IOFB) after hammering metal. He has a small conjunctival laceration with a self-sealing corneal entry wound. The BEST initial imaging investigation to confirm and localise the IOFB is:
- A High-resolution CT scan of the orbit without contrast ✓
- B Plain X-ray (AP and lateral views of the orbit)
- C B-scan ultrasonography
- D MRI of the orbit
Correct answer: A. High-resolution CT scan of the orbit without contrast
Explanation
CT of the orbit (non-contrast, thin sections, axial and coronal) is the gold standard for detecting metallic IFBs, providing precise localisation relative to intraocular structures and allowing surgical planning. Plain X-ray may miss small or posterior IFBs. B-scan should be used cautiously in open globe injuries (pressure on the eye). MRI is absolutely contraindicated if the IOFB may be ferromagnetic (most industrial metal fragments), due to risk of movement and further ocular damage.
Reference: Khurana Comprehensive Ophthalmology, 7th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.